Antimicrobial resistance patterns and treatment outcomes of S. suis infections in Southeast Asia

Announcing a new article publication for Zoonoses journal. This study was aimed at conducting a systematic review and meta-analysis of antimicrobial resistance patterns and treatment outcomes of S. suis infections in Southeast Asia, where this zoonotic pathogen poses a major public health concern through consumption of raw or undercooked pork.

A systematic review and meta-analysis were conducted by searching nine databases through December 2024. Studies reporting antimicrobial resistance profiles of S. suis isolates or clinical outcomes among infected patients from Southeast Asian countries were eligible for inclusion. Pooled estimates were calculated with random-effects meta-analysis, and country-stratified analyses were performed to explore temporal resistance dynamics.

Ten eligible studies from Thailand and Vietnam were identified, contributing 763 bacterial isolates and 618 patients. The pooled penicillin resistance was 2% (95% CI: 0-18%), and substantial heterogeneity was observed across studies (I² = 68.8%). Country-stratified analysis revealed distinct temporal patterns: Thailand demonstrated non-linear resistance dynamics, whereas Vietnam maintained consistently low resistance throughout the study period. The pooled mortality was 16% (95% CI: 11-22%) in humans. Ceftriaxone, penicillin, and vancomycin remained effective first-line treatment options.

Although penicillin resistance remains low overall, reports of intermediate resistance warrant continual regional surveillance and strengthened antibiotic stewardship in pig farming. These findings should be interpreted cautiously, given the limited eligible studies and substantial heterogeneity.